ABSTRACT
Objectives: Febrile neutropenia (FN) is a severe complication of chemotherapy, associated with increased morbidity and mortality. This study aimed to estimate the clinical and economic burden of hospitalization for FN among cancer patients treated with chemotherapy in France. We focused on lung cancer, the most common cancer type associated with FN. Method(s): Using a French nationwide hospital database (PMSI), we included all newly diagnosed patients receiving intravenous chemotherapy to treat lung cancer between January 2017 and November 2020 who were hospitalized for FN the month following their admission for chemotherapy during their first year of treatment. The number and characteristics of patients, as well as the number and length of stay, hospital cost, and inpatient mortality, are described. Result(s): The incidence of patients with lung cancer experiencing chemotherapy-induced FN slightly decreased from 3,050 (incidence rate of 10.8%) in 2017 to 2,725 (incidence rate of 9.4%) in 2020. Majority of patients with lung cancer and FN were male (68.7%), with a mean (SD) age of 66.7 (9.0) years in 2020. The in-hospital FN-related death rate was also constant at 16.4% in 2020. The number of stays for FN slightly decreased (2017: 3,802;2020: 3,294 stays, whereas the average length of stay per patient remained stable with 10.5 days in 2020. The average costs rose from 5,305 to 5,539 per stay and per patient. Conclusion(s): Although the proportion of French patients with lung cancer hospitalized for chemotherapy-induced FN decreased from 10.8% in 2017 to 9.4% in 2020, possibly because of the covid epidemy, the number of hospitalizations remained high, as did the proportion of in-hospital FN-related deaths. These figures highlight a real public health problem, and thus further research is needed for FN prevention. Copyright © 2022
ABSTRACT
Objective: Describe characteristics of patients who self-inject denosumab and patterns of self-injection in France. Methods: PILOTE was a prospective observational study that evaluated persistence to denosumab over 24 months in France in postmenopausal women. Clinical information obtained through routine practice was recorded onto an eCRF, including the individual who injected subcutaneous denosumab (physician, nurse, patient, other). We conducted an ad hoc analysis of the patients in the study who self-injected denosumab. Results: In total, 478 patients were enrolled between June 2105 and February 2016. 27 patients self-injected denosumab at least once, with these patients distributed across multiple sites. Those who self-injected appeared slightly younger with longer duration of osteoporosis, and a higher proportion had a prior fracture and previous glucocorticoid and teriparatide treatment than the overall population (Table). Self-injected patients were also more likely to be living at home with family, have a University education, and be seen by a rheumatologist than a GP. Twelve patients self-injected from the beginning of the study, 15 self-injected after receiving injection from an HCP and 8 switched back to HCP injections after self-injection. Eleven of the 12 patients who self-injected from the beginning were persistent at 24 months. Six ADRs occurred in three self-injecting patients: one vertebral fracture, bone pain, muscle fatigue, myalgia, asthenia, pyelonephritis. Conclusion: Although numbers were small, self- administration of denosumab appeared feasible for women with postmenopausal osteoporosis and may be a valuable option, particularly in the context of the COVID-19 pandemic when office visits are restricted. (Table Presented).